PresRecRF: Herbal prescription recommendation via the representation fusion of large TCM semantics and molecular knowledge.

BACKGROUND: Herbal prescription recommendation (HPR) is a hotspot in the research of clinical intelligent decision support. Recently plentiful HPR models based on deep neural networks have been proposed. Owing to insufficient data, e.g., lack of knowledge of molecular, TCM theory, and herbal dosage in HPR modeling, the existing models suffer from challenges, e.g., plain prediction precision, and are far from real-world clinics. PURPOSE: To address these problems, we proposed a novel herbal prescription recommendation model with the representation fusion of large TCM semantics and molecular knowledge (termed PresRecRF). STUDY DESIGN AND METHODS: PresRecRF comprises three key modules. The representation learning module consists of two key components: a molecular knowledge representation component, integrating molecular knowledge into the herb-symptom-protein knowledge graph to enhance representations for herbs and symptoms; and a TCM knowledge representation component, leveraging BERT and ChatGPT to acquire TCM knowledge-enriched semantic representations. We introduced a representation fusion module to effectively merge molecular and TCM semantic representations. In the herb recommendation module, a multi-task objective loss is implemented to predict both herbs and dosages simultaneously. RESULTS: The experimental results on two clinical datasets show that PresRecRF can achieve the optimal performance. Further analysis of ablation, hyper-parameters, and case studies indicate the effectiveness and reliability of the proposed model, suggesting that it can help precision medicine and treatment recommendations. CONCLUSION: The entire process of the proposed PresRecRF model closely mirrors the actual diagnosis and treatment procedures carried out by doctors, which are better applied in real clinical scenarios. The source codes of PresRecRF is available at https://github.com/2020MEAI/PresRecRF.

A decentralized federated learning-based cancer survival prediction method with privacy protection.

Background: Survival prediction is one of the crucial goals in precision medicine, as accurate survival assessment can aid physicians in selecting appropriate treatment for individual patients. To achieve this aim, extensive data must be utilized to train the prediction model and prevent overfitting. However, the collection of patient data for disease prediction is challenging due to potential variations in data sources across institutions and concerns regarding privacy and ownership issues in data sharing. To facilitate the integration of cancer data from different institutions without violating privacy laws, we developed a federated learning-based data integration framework called AdFed, which can be used to evaluate patients' survival while considering the privacy protection problem by utilizing the decentralized federated learning technology and regularization method. Results: AdFed was tested on different cancer datasets that contain the patients' information from different institutions. The experimental results show that AdFed using distributed data can achieve better performance in cancer survival prediction (AUC = 0.605) than the compared federated-learning-based methods (average AUC = 0.554). Additionally, to assess the biological interpretability of our method, in the case study we list 10 identified genes related to liver cancer selected by AdFed, among which 5 genes have been proved by literature review. Conclusions: The results indicate that AdFed outperforms better than other federated-learning-based methods, and the interpretable algorithm can select biologically significant genes and pathways while ensuring the confidentiality and integrity of data.

MRI-based deep learning and radiomics for prediction of occult cervical lymph node metastasis and prognosis in early-stage oral and oropharyngeal squamous cell carcinoma: a diagnostic study.

INTRODUCTION: The incidence of occult cervical lymph node metastases (OCLNM) is reported to be 20-30% in early-stage oral cancer and oropharyngeal cancer. There is a lack of an accurate diagnostic method to predict occult lymph node metastasis and to help surgeons make precise treatment decisions. AIM: To construct and evaluate a preoperative diagnostic method to predict OCLNM in early-stage oral and oropharyngeal squamous cell carcinoma (OC and OP SCC) based on deep learning features (DLFs) and radiomics features. METHODS: A total of 319 patients diagnosed with early-stage OC or OP SCC were retrospectively enrolled and divided into training, test and external validation sets. Traditional radiomics features and DLFs were extracted from their MRI images. The least absolute shrinkage and selection operator (LASSO) analysis was employed to identify the most valuable features. Prediction models for OCLNM were developed using radiomics features and DLFs. The effectiveness of the models and their clinical applicability were evaluated using the area under the curve (AUC), decision curve analysis (DCA), and survival analysis. RESULTS: Seventeen prediction models were constructed. The Resnet50 deep learning (DL) model based on the combination of radiomics and DL features achieves the optimal performance, with AUC values of 0.928 (95% CI: 0.881-0.975), 0.878 (95% CI: 0.766-0.990), 0.796 (95% CI: 0.666-0.927), and 0.834 (95% CI: 0.721-0.947) in the training, test, external validation set1, and external validation set2, respectively. Moreover, the Resnet50 model has great prediction value of prognosis in patients with early-stage OC and OP SCC. CONCLUSION: The proposed MRI-based Resnet50 DL model demonstrated high capability in diagnosis of OCLNM and prognosis prediction in the early-stage OC and OP SCC. The Resnet50 model could help refine the clinical diagnosis and treatment of the early-stage OC and OP SCC.

PresRecST: a novel herbal prescription recommendation algorithm for real-world patients with integration of syndrome differentiation and treatment planning.

OBJECTIVES: Herbal prescription recommendation (HPR) is a hot topic and challenging issue in field of clinical decision support of traditional Chinese medicine (TCM). However, almost all previous HPR methods have not adhered to the clinical principles of syndrome differentiation and treatment planning of TCM, which has resulted in suboptimal performance and difficulties in application to real-world clinical scenarios. MATERIALS AND METHODS: We emphasize the synergy among diagnosis and treatment procedure in real-world TCM clinical settings to propose the PresRecST model, which effectively combines the key components of symptom collection, syndrome differentiation, treatment method determination, and herb recommendation. This model integrates a self-curated TCM knowledge graph to learn the high-quality representations of TCM biomedical entities and performs 3 stages of clinical predictions to meet the principle of systematic sequential procedure of TCM decision making. RESULTS: To address the limitations of previous datasets, we constructed the TCM-Lung dataset, which is suitable for the simultaneous training of the syndrome differentiation, treatment method determination, and herb recommendation. Overall experimental results on 2 datasets demonstrate that the proposed PresRecST outperforms the state-of-the-art algorithm by significant improvements (eg, improvements of P@5 by 4.70%, P@10 by 5.37%, P@20 by 3.08% compared with the best baseline). DISCUSSION: The workflow of PresRecST effectively integrates the embedding vectors of the knowledge graph for progressive recommendation tasks, and it closely aligns with the actual diagnostic and treatment procedures followed by TCM doctors. A series of ablation experiments and case study show the availability and interpretability of PresRecST, indicating the proposed PresRecST can be beneficial for assisting the diagnosis and treatment in real-world TCM clinical settings. CONCLUSION: Our technology can be applied in a progressive recommendation scenario, providing recommendations for related items in a progressive manner, which can assist in providing more reliable diagnoses and herbal therapies for TCM clinical task.